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dc.contributor.authorJohansson, Kjell Arneeng
dc.contributor.authorRobberstad, Bjarneeng
dc.contributor.authorNorheim, Ole Frithjofeng
dc.identifier.citationAIDS Research and Therapy 7:3en_US
dc.description.abstractBackground International HIV guidelines have recently shifted from a medium-late to an early-start treatment strategy. As a consequence, more people will be eligible to Highly Active Antiretroviral Therapy (HAART). We estimate mean life years gained using different treatment indications in low income countries. Methods We carried out a systematic search to identify relevant studies on the treatment effect of HAART. Outcome from identified observational studies were combined in a pooled-analyses and we apply these data in a Markov life cycle model based on a hypothetical Tanzanian HIV population. Survival for three different HIV populations with and without any treatment is estimated. The number of patients included in our pooled-analysis is 35 047. Results Providing HAART early when CD4 is 200-350 cells/μl is likely to be the best outcome strategy with an expected net benefit of 14.5 life years per patient. The model predicts diminishing treatment benefits for patients starting treatment when CD4 counts are lower. Patients starting treatment at CD4 50-199 and <50 cells/μl have expected net health benefits of 7.6 and 7.3 life years. Without treatment, HIV patients with CD4 counts 200-350; 50-199 and < 50 cells/μl can expect to live 4.8; 2.0 and 0.7 life years respectively. Conclusions This study demonstrates that HIV patients live longer with early start strategies in low income countries. Since low income countries have many constraints to full coverage of HAART, this study provides input to a more transparent debate regarding where to draw explicit eligibility criteria during further scale up of HAART.en_US
dc.publisherBioMed Centraleng
dc.rightsAttribution CC BYeng
dc.titleFurther benefits by early start of HIV treatment in low income countries: Survival estimates of early versus deferred antiretroviral therapyeng
dc.typePeer reviewedeng
dc.typeJournal articleeng
dc.rights.holderCopyright 2010 Johansson et al; licensee BioMed Central Ltd.
dc.rights.holderJohansson et al.eng
bora.peerreviewedPeer reviewedeng

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